Nutrition and Cancer Treatment

Authored by: David Heber , Susan Bowerman

Handbook of Nutrition and Food

Print publication date:  July  2013
Online publication date:  April  2016

Print ISBN: 9781466505711
eBook ISBN: 9781466505728
Adobe ISBN:

10.1201/b15294-73

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Abstract

Malnutrition is a frequent and serious problem in patients with cancer. Patients with lung, prostate, head and neck, and gastric cancers are more frequently affected, but the overall incidence of malnutrition ranges between 30% and 85% of different populations studied. 1 , 2 The advanced starvation state resulting from decreased food intake and hormonal/metabolic abnormalities characteristic of the interaction between tumor and host has been called cancer cachexia, 3 characterized by progressive, involuntary weight loss with depletion of lean body mass, muscle wasting and weakness, edema, impaired immune response, and declines in motor and mental function. Weight loss of greater than 10% of prediagnosis weight is seen in approximately 45% of patients. 2 , 4 Cancer-associated malnutrition and cachexia are related to considerable morbidity and mortality, including decreased quality of life, 5 impaired response to chemotherapy, 5 impaired muscle function, 6 and higher incidence of postoperative complications. 7 9 The goals of nutritional support are to provide the patient with energy and nutrients to maintain or improve their nutritional status and immune function, minimize gastrointestinal (GI) symptoms, and improve quality of life. Early intervention in adequately nourished patients or those with early signs of nutritional decline can delay the progression of malnutrition, 10 but a vicious cycle of cachexia can develop in which the effects of the disease lead to nutritional decline, predisposing the patient to increased complications and more severe disease, which promotes further decline.

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